CONGRESS ABSTRACT

Background: Appropriate interpretation of kidney function is essential for clinical and therapeutic management of heart failure (HF). In HF patients, chronic kidney disease plays a critical role and impacts prognosis. In this study we aimed at evaluating the prognostic accuracy of five glomerular filtration rate (GFR) estimation formulas in HF patients with reduced ejection fraction (HFrEF) and their impact on the Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score. Methods: We retrospectively analyzed 6,933 patients enrolled in the Metabolic Exercise Cardiac Kidney Indexes (MECKI) score database. GFR was estimated using five different formulas: the Modification of Diet in Renal Disease (MDRD); the MRDR modified (MDRDm); the Cockcroft-Gault (CG), the CG modified (CGm); and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). The primary endpoint of the study was the composite of cardiovascular death, left ventricular assist device implantation, and urgent heart transplantation at 2 years. Results: Table 1 shows the main characteristics of the population. The median follow-up was 4.2 years (IQR 1.8-7.6). Each GFR estimation demonstrated similar but moderate prognostic capacity (AUC range: 0.6278-0.6351), with the MDRD equation showing the best performance (Figure 1, left). Employment of eGFR according to the 5 different formulas in the MECKI score calculation did not significantly alter its prognostic power (AUC ranging from 0.7841 to 0.7883), Figure 1, right. Conclusions. While GFR estimation methods exhibit moderate prognostic capacity with only slight variations existing in the prognostic performance of different GFR estimation methods, the MECKI score remains a reliable tool for risk prediction in HFrEF, facilitating individualized treatment decisions in HF management. Individualized risk assessment based on patient-specific characteristics should inform clinical decision-making in HF management, warranting further exploration and validation in future studies.in risk stratification.